Multimodal Imaging and Theranostic Laboratory, Cardiovascular Center, Korea University Guro Hospital, 148 Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
Cardiovascular Center, Korea University Guro Hospital, 148 Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
Sci Rep. 2023 Aug 24;13(1):13818. doi: 10.1038/s41598-023-40363-7.
Intracoronary optical coherence tomography (OCT) requires injection of flushing media for image acquisition. Alternative flushing media needs to be investigated to reduce the risk of contrast-induced renal dysfunction. We investigated the feasibility and safety of pentastarch (hydroxyethyl starch) for clinical OCT imaging. We prospectively enrolled 43 patients with 70 coronary lesions (46-stented; 24-native). Total 81 OCT pullback pairs were obtained by manual injection of iodine contrast, followed by pentastarch. Each pullback was assessed frame-by-frame using an automated customized lumen contour/stent strut segmentation algorithm. Paired images were compared for the clear image segments (CIS), blood-flushing capability, and quantitative morphometric measurements. Overall image quality, as assessed by the proportion of CIS, was comparable between the contrast- and pentastarch-flushed images (97.1% vs. 96.5%; p = 0.160). The pixel-based blood-flushing capability was similar between the groups (0.951 [0.947-0.953] vs. 0.950 [0.948-0.952], p = 0.125). Quantitative two- and three-dimensional morphometric measurements of the paired images correlated well (p < 0.001) with excellent inter-measurement variability. All patients safely underwent OCT imaging using pentastarch without resulting in clinically relevant complications or renal deterioration. Non-contrast OCT imaging using pentastarch is clinically safe and technically feasible with excellent image quality and could be a promising alternative strategy for patients at high risk of renal impairment.
冠状动脉内光学相干断层成像术（OCT）需要注射冲洗介质以获取图像。需要研究替代冲洗介质以降低造影剂诱导的肾功能障碍的风险。我们研究了戊聚糖（羟乙基淀粉）用于临床 OCT 成像的可行性和安全性。前瞻性纳入了 43 例 70 处冠状动脉病变患者（46 处支架置入；24 处为 native）。通过手动注射碘造影剂，随后注射戊聚糖，共获得 81 对 OCT 回撤。使用自动定制的管腔轮廓/支架支柱分割算法逐帧评估每个回撤。比较配对图像的清晰图像段（CIS）、血液冲洗能力和定量形态测量结果。通过 CIS 的比例评估整体图像质量，造影剂和戊聚糖冲洗图像之间无显著差异（97.1%比 96.5%；p=0.160）。两组之间的基于像素的血液冲洗能力相似（0.951[0.947-0.953]比 0.950[0.948-0.952]，p=0.125）。配对图像的定量二维和三维形态测量结果相关性良好（p<0.001），测量间变异性良好。所有患者均安全地接受了戊聚糖非对比 OCT 成像，没有导致临床相关并发症或肾功能恶化。使用戊聚糖的非对比 OCT 成像具有良好的临床安全性和技术可行性，图像质量优异，可能是肾功能受损高危患者的一种有前途的替代策略。
